[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-436081-105":59,"doc-detail-436081-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","lymphovenous-shunts-in-the-treatment-of-lymphedema","Lymphovenous Shunts in the Treatment of Lymphedema","","Lymphedema is a progressive condition without a known cure, marked by lymphatic fluid accumulation and limb swelling. While conservative measures such as compression therapy and physical rehabilitation remain important, surgical strategies are increasingly used for more durable symptom relief. Lymphovenous shunts, first described in the 1960s, have gained attention over recent decades as imaging, optics, and surgical instrumentation improved. This review analyzes key lymphovenous shunt approaches, including lymphatic implantation, lymph node-to-vein anastomoses, DALF-VW, and supermicrosurgical lymphovenous anastomoses.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/lymphovenous-shunts-in-the-treatment-of-lymphedema/436081/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/lymphovenous-shunts-in-the-treatment-of-lymphedema/436081.png","ImageObject",300,407,{"name":92,"@type":93},"Liam","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What makes lymphedema difficult to treat?","Question",{"text":112,"@type":113},"Lymphedema is described as progressive with no known cure. It is characterized by lymphatic fluid accumulation leading to swelling in affected limbs.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why have lymphovenous shunts attracted increasing interest in recent decades?",{"text":117,"@type":113},"Attention has grown because advances in optics, imaging, and surgical instruments have improved surgical feasibility and understanding.",{"name":119,"@type":110,"acceptedAnswer":120},"Which lymphovenous shunt techniques are reviewed for lymphedema treatment?",{"text":121,"@type":113},"The review discusses lymphatic implantation, lymph node-to-vein anastomoses (LNVAs), dermal-adipose lymphatic flap venous wrapping (DALF-VW), and supermicrosurgical lymphovenous anastomoses (LVAs).","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},436081,1790789719,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},8796095461564,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","J Chin MedAssoc  \nReview ARticle  \nLymphovenous shunts in the treatment of lymphedema  \nJeremy Mingfa Suna,b, Takumi Yamamotob,*  \naDepartment of Surgery, Plastic Reconstructive and Aesthetic Surgery Service, Changi General Hospital, Singapore,  \nSingapore; bDepartment of Plastic and Reconstructive Surgery, National Center for Global Health and Medicine, Tokyo, Japan  \nAbstract  \nLymphedema is a progressive disease with no known cure. Characterized by the accumulation of lymphatic fluid and subsequent swelling in the affected limbs, it often poses significant challenges to those living with it. Although various conservative treatments have been used to manage lymphedema, such as compression therapy and physical rehabilitation, surgical interventions have emerged as promising avenues for more substantial relief. Lymphovenous shunts have been described since the 1960s and have garnered much attention in the recent two decades due to technological advances in optics, imaging, and surgical instruments. This review article explores the use of different lymphovenous shunts such as lymphatic implantation, lymph node-to-vein anastomoses (LNVAs), dermal-adipose lymphatic flap venous wrapping (DALF-VW), and supermicrosurgical lymphovenous anastomoses (LVAs) as treatment modalities for lymphedema. We will discuss the underlying principles, indications, techniques, and potential benefits. By examining the current state of knowledge and ongoing research in the field, we aim to provide insights into the role of lymphovenous shunts in the comprehensive management of lymphedema and shed light on the prospects for this treatment option.  \nKeywords: Dermal-adipose lymphatic flap venous wrapping; Lymph node-to-vein anastomosis; Lymphatic implantation; Lymphovenous shunt; Supermicrosurgical lymphovenous anastomosis  \n1. INTRODUCTION  \nAdvances in in-vivo imaging technology have allowed researchers to gain more insights into the interstitium. We now understand that afflictions of the interstitium, and their drainage system, the lymphatics, account for some of the pathologieswe encounter today. Benias et al1 described a network of submucosal channels known as the submucosal interstitium in the digestive and urinary tracts that facilitates the transmission of tumor cells once luminal invasive tumors reach the submucosa. Metastasis is then promoted through the lymphatics and lymphovenous shunts (LVSs) in the body. A LVS or lymphovenous communication connects the lymphatic and venous systems. They can be classified as physiological, pathological, or iatrogenic/surgical based on their etiology.2  \nPhysiological LVSs exist in individuals with normal lymphatics. The anastomoses between the thoracic duct and the subclavian vein represent well-known LVSs. Hidden et al3 stated that there is a physiological necessity for LVS in points other than the terminal entry of the thoracic duct into the superior caval system. LVSs between the thoracic duct and the azygous system  \n* Address correspondence. Dr. Takumi Yamamoto, Department of Plastic and Reconstructive Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan. E-mail address: tyamamoto-tky@ [umin.ac.jp](umin.ac.jp) (T. Yamamoto).  \nConflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2024) 87: 5-11.  \nReceived July 10, 2023; accepted August 13, 2023. doi: 10. 1097/JCMA.0000000000001016  \nCopyright © 2023, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/))  \nhave been reported in the literature,4 although their physiological or physiological etiology is still up for debate. Some authors believe physiological shunts only open w","cbCaisg3PiTR8bR8","https://ap.wps.com/l/cbCaisg3PiTR8bR8","pdf",474076,"English","# Introduction\n## Physiological lymphovenous shunts\n## Pathological lymphovenous shunts\n## Surgical lymphovenous shunts and technique evolution\n# Lymphatic implantation (lymphovenous implantation)","[{\"question\":\"What makes lymphedema difficult to treat?\",\"answer\":\"Lymphedema is described as progressive with no known cure. It is characterized by lymphatic fluid accumulation leading to swelling in affected limbs.\"},{\"question\":\"Why have lymphovenous shunts attracted increasing interest in recent decades?\",\"answer\":\"Attention has grown because advances in optics, imaging, and surgical instruments have improved surgical feasibility and understanding.\"},{\"question\":\"Which lymphovenous shunt techniques are reviewed for lymphedema treatment?\",\"answer\":\"The review discusses lymphatic implantation, lymph node-to-vein anastomoses (LNVAs), dermal-adipose lymphatic flap venous wrapping (DALF-VW), and supermicrosurgical lymphovenous anastomoses (LVAs).\"}]","Lymphovenous Shunts in the Treatment of Lymphedema | PDF",1790676696,18]